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Would Legalizing Physician-Assisted Suicide Endanger People with Disabilities?

Not Dead Yet, a disability rights organization, explained in the "About Us" portion of its website (accessed Nov. 28, 2006):

"Though often described as compassionate, legalized medical killing is really about a deadly double standard for people with severe disabilities, including both conditions that are labeled terminal and those that are not. Disability opposition to this ultimate form of discrimination has been ignored by most media and courts, but countless people with disabilities have already died before their time...

Legalized medical killing is not a new human right, it's a new professional immunity. It would allow health professionals to decide which of us are 'eligible' for this service, and exempt them from accountability for their decisions. Killing is not just another medical treatment option, and it must not be made any part of routine health care. In these days of cost cutting and managed care, we don't trust the health care system, and neither should you."

The National Council on Disability argued in its Mar. 24, 1997 position paper, "Assisted Suicide: A Disability Perspective," written by Robert Burgdorf Jr., JD:

"Current evidence indicates clearly that the interests of the few people who would benefit from legalizing physician-assisted suicide are heavily outweighed by the probability that any law, procedures, and standards that can be imposed to regulate physician-assisted suicide will be misapplied to unnecessarily end the lives of people with disabilities and entail an intolerable degree of intervention by legal and medical officials in such decisions. On balance, the current illegality of physician-assisted suicide is preferable to the limited benefits to be gained by its legalization. At least until such time as our society provides a comprehensive, fully-funded, and operational system of assistive living services for people with disabilities, this is the only position that the National Council on Disability can, in good conscience, support."

Rhoda Olkin, PhD, Professor at the California School of Professional Psychology, Alliant International University, wrote in her Summer 2005 article "Why I Changed My Mind About Physician-Assisted Suicide: How Stanford University Made a Radical Out of Me," that appeared in the Journal of Disability Policy Studies:

"People with disabilities are more likely than those without disabilities to live below the poverty line, to be without insurance, and to use government insurance versus private insurers...

Many persons with disabilities have personal histories of traumas and objectification at the hands of doctors, and there is a distrust, if not an antipathy, in the disability community toward medical professionals. Having two doctors (or, just as likely, employees of a health maintenance organization) making a determination of informed consent does not seem like an adequate safeguard for people with disabilities...

Inherent in the request for PAS [physician-assisted suicide] is the idea that one's quality of remaining life is sufficiently impaired that continued life would be cruel. But people without disabilities judge the quality of the lives of people with disabilities more harshly than do the people with disabilities themselves. If professionals think that of course the disabled person would want to die, might not these expectations play a disheartening role in someone's decision to seek PAS? Would a request for PAS from a person with disabilities be subject to less scrutiny because the decision makes sense to others?...

In a society in which people with disabilities are one of the most disadvantaged minority groups, we do not have the luxury of thinking of PAS as a final act of self-determination. We are a vulnerable population, subject to forced sterilization, ostracization, stigma, and discrimination. It is not paternalistic to think that people with disabilities will be coerced into PAS (or killed without their permission); to argue that people with disabilities have as much free will as the nondisabled is to ignore the oppression of people with disabilities."

Andrew Batavia, JD, former Associate Professor of Health Law and Policy at Florida International University, wrote in his article "Disability and Physician-Assisted Dying" that appeared in the 2004 book Physician-Assisted Dying: The Case for Palliative Care & Patient Choice:

"Like any politically, ethnically, and religiously diverse community, there is a wide range of opinions among members of the disability community on this issue. Contrary to claims made by Not Dead Yet, there is some evidence that a majority of people with disabilities support a right to assisted suicide for terminally ill individuals...

We do not believe that the right to assisted suicide is premised on a diminished quality of life for people with disabilities. It is based on respect for the autonomy of terminally ill individuals during their final days... It does not deny people with disabilities suicide prevention services, protection against murder, or protection from other abuses. We further contend that, though we must always be vigilant in preventing abuses, the right will not necessarily be expanded to individuals or situations for which it was not intended...

Those who oppose a right to assisted suicide predict that a substantial number of people with disabilities would be killed against their will if assisted suicide were legalized. However, there is no evidence that this has happened to people on life-support systems, who have had the right to die at least since the Cruzan decision in 1990. We believe that abuses of assisted suicide, to the extent they are now occurring behind closed doors, are less likely to continue once assisted suicide is legalized and appropriately regulated."

In Compassion in Dying v. Washington (1996), the United States 9th Circuit Court of Appeals, in a decision delivered by Circuit Judge Stephen Reinhardt, stated:

"One of the [lower court] majority's prime arguments is that the statute [outlawing physician-assisted suicide] is necessary to protect 'the poor and minorities from exploitation,'-- in other words, to protect the disadvantaged from becoming the victims of assisted suicide. This rationale simply recycles one of the more disingenuous and fallacious arguments raised in opposition to the legalization of abortion. It is equally meretricious here... The argument that disadvantaged persons will receive more medical services than the remainder of the population in one, and only one, area -- assisted suicide -- is ludicrous on its face. So, too, is the argument that the poor and the minorities will rush to volunteer for physician-assisted suicide because of their inability to secure adequate medical treatment.

Our analysis is similar regarding the argument relating to the handicapped. Again, the opponents of physician-assisted suicide urge a variation of the discredited anti-abortion argument. Despite the dire predictions, the disabled were not pressured into seeking abortions. Nor is it likely that the disabled will be pressured into committing physician-assisted suicide. Organizations representing the physically impaired are sufficiently active politically and sufficiently vigilant that they would soon put a halt to any effort to employ assisted suicide in a manner that affected their clients unfairly. There are other more subtle concerns, however, advanced by some representatives of the physically impaired, including the fear that certain physical disabilities will erroneously be deemed to make life 'valueless.' While we recognize the legitimacy of these concerns, we also recognize that seriously impaired individuals will, along with non-impaired individuals, be the beneficiaries of the liberty interest asserted here -- and that if they are not afforded the option to control their own fate, they like many others will be compelled, against their will, to endure unusual and protracted suffering. The resolution that would be best for all, of course, would be to ensure that the practice of assisted suicide is conducted fairly and well, and that adequate safeguards sufficient to avoid the feared abuses are adopted and enforced."